The Screening for Occult Renal Disease (SCORED) value is associated with a higher risk for having or developing chronic kidney disease in patients treated for small, unilateral renal masses

Steven M. Lucas, Geoffrey Nuss, Joshua Stern, Yair Lotan, Arthur I Sagalowsky, Jeffrey A Cadeddu, Ganesh Raj

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Abstract

BACKGROUND. Patients with renal masses are at risk for having or developing chronic kidney disease (CKD) stage 3 (glomerular filtration rate [GFR] <60 mL per minute/1.73 m2). In this study, the authors investigated whether the Screening for Occult Renal Disease (SCORED) model could identify patients with renal masses who were at risk for having or developing CKD. METHODS. Two hundred forty-two consecutive patients with unilateral T1a renal masses who underwent treatment were reviewed retrospectively. The GFR was estimated by using the Modification of Diet in Renal Disease equation. SCORED values were stratified as low (<4) or high (≥4). Kaplan-Meier survival curves (with log-rank comparison) were used to compute the risk of developing CKD. RESULTS. Before intervention, 65 of 242 patients (27%) with T1a renal masses had CKD, including 10 of 98 patients (10%) with low SCORED values and 55 of 144 patients (38%) with high SCORED values. Interventions included radical nephrectomy (RN) in 71 patients (29%) and nephron-sparing approaches (NSA) in 171 patients (71%). Among patients with normal preoperative renal function, those with low SCORED values were less likely to develop CKD than those with high SCORED values, whether they underwent RN (38% vs 82%; P <.001) or NSA (14% vs 22%; P = .01). Multivariate analyses revealed that high SCORED values (hazard ratio [HR], 2.9; P =.02) and RN (HR, 7.0; P <.001) were significant predictors of developing CKD. CONCLUSIONS. High SCORED values were associated with a higher risk for having or developing CKD in patients who underwent intervention for small, unilateral renal masses. These data suggest that NSA should be used whenever possible, and SCORED risk stratification should be used in counseling patients regarding their potential risk of CKD.

Original languageEnglish (US)
Pages (from-to)2681-2686
Number of pages6
JournalCancer
Volume113
Issue number10
DOIs
StatePublished - Nov 15 2008

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Chronic Renal Insufficiency
Kidney
Nephrons
Nephrectomy
Glomerular Filtration Rate
Diet Therapy
Kaplan-Meier Estimate
Counseling

Keywords

  • Chronic kidney disease
  • Nephrectomy
  • Predictive model
  • Renal cancer
  • Screening for Occult Renal Disease Value

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{038eddd737e84eb2bfa91fdf2dae40cc,
title = "The Screening for Occult Renal Disease (SCORED) value is associated with a higher risk for having or developing chronic kidney disease in patients treated for small, unilateral renal masses",
abstract = "BACKGROUND. Patients with renal masses are at risk for having or developing chronic kidney disease (CKD) stage 3 (glomerular filtration rate [GFR] <60 mL per minute/1.73 m2). In this study, the authors investigated whether the Screening for Occult Renal Disease (SCORED) model could identify patients with renal masses who were at risk for having or developing CKD. METHODS. Two hundred forty-two consecutive patients with unilateral T1a renal masses who underwent treatment were reviewed retrospectively. The GFR was estimated by using the Modification of Diet in Renal Disease equation. SCORED values were stratified as low (<4) or high (≥4). Kaplan-Meier survival curves (with log-rank comparison) were used to compute the risk of developing CKD. RESULTS. Before intervention, 65 of 242 patients (27{\%}) with T1a renal masses had CKD, including 10 of 98 patients (10{\%}) with low SCORED values and 55 of 144 patients (38{\%}) with high SCORED values. Interventions included radical nephrectomy (RN) in 71 patients (29{\%}) and nephron-sparing approaches (NSA) in 171 patients (71{\%}). Among patients with normal preoperative renal function, those with low SCORED values were less likely to develop CKD than those with high SCORED values, whether they underwent RN (38{\%} vs 82{\%}; P <.001) or NSA (14{\%} vs 22{\%}; P = .01). Multivariate analyses revealed that high SCORED values (hazard ratio [HR], 2.9; P =.02) and RN (HR, 7.0; P <.001) were significant predictors of developing CKD. CONCLUSIONS. High SCORED values were associated with a higher risk for having or developing CKD in patients who underwent intervention for small, unilateral renal masses. These data suggest that NSA should be used whenever possible, and SCORED risk stratification should be used in counseling patients regarding their potential risk of CKD.",
keywords = "Chronic kidney disease, Nephrectomy, Predictive model, Renal cancer, Screening for Occult Renal Disease Value",
author = "Lucas, {Steven M.} and Geoffrey Nuss and Joshua Stern and Yair Lotan and Sagalowsky, {Arthur I} and Cadeddu, {Jeffrey A} and Ganesh Raj",
year = "2008",
month = "11",
day = "15",
doi = "10.1002/cncr.23850",
language = "English (US)",
volume = "113",
pages = "2681--2686",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "10",

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T1 - The Screening for Occult Renal Disease (SCORED) value is associated with a higher risk for having or developing chronic kidney disease in patients treated for small, unilateral renal masses

AU - Lucas, Steven M.

AU - Nuss, Geoffrey

AU - Stern, Joshua

AU - Lotan, Yair

AU - Sagalowsky, Arthur I

AU - Cadeddu, Jeffrey A

AU - Raj, Ganesh

PY - 2008/11/15

Y1 - 2008/11/15

N2 - BACKGROUND. Patients with renal masses are at risk for having or developing chronic kidney disease (CKD) stage 3 (glomerular filtration rate [GFR] <60 mL per minute/1.73 m2). In this study, the authors investigated whether the Screening for Occult Renal Disease (SCORED) model could identify patients with renal masses who were at risk for having or developing CKD. METHODS. Two hundred forty-two consecutive patients with unilateral T1a renal masses who underwent treatment were reviewed retrospectively. The GFR was estimated by using the Modification of Diet in Renal Disease equation. SCORED values were stratified as low (<4) or high (≥4). Kaplan-Meier survival curves (with log-rank comparison) were used to compute the risk of developing CKD. RESULTS. Before intervention, 65 of 242 patients (27%) with T1a renal masses had CKD, including 10 of 98 patients (10%) with low SCORED values and 55 of 144 patients (38%) with high SCORED values. Interventions included radical nephrectomy (RN) in 71 patients (29%) and nephron-sparing approaches (NSA) in 171 patients (71%). Among patients with normal preoperative renal function, those with low SCORED values were less likely to develop CKD than those with high SCORED values, whether they underwent RN (38% vs 82%; P <.001) or NSA (14% vs 22%; P = .01). Multivariate analyses revealed that high SCORED values (hazard ratio [HR], 2.9; P =.02) and RN (HR, 7.0; P <.001) were significant predictors of developing CKD. CONCLUSIONS. High SCORED values were associated with a higher risk for having or developing CKD in patients who underwent intervention for small, unilateral renal masses. These data suggest that NSA should be used whenever possible, and SCORED risk stratification should be used in counseling patients regarding their potential risk of CKD.

AB - BACKGROUND. Patients with renal masses are at risk for having or developing chronic kidney disease (CKD) stage 3 (glomerular filtration rate [GFR] <60 mL per minute/1.73 m2). In this study, the authors investigated whether the Screening for Occult Renal Disease (SCORED) model could identify patients with renal masses who were at risk for having or developing CKD. METHODS. Two hundred forty-two consecutive patients with unilateral T1a renal masses who underwent treatment were reviewed retrospectively. The GFR was estimated by using the Modification of Diet in Renal Disease equation. SCORED values were stratified as low (<4) or high (≥4). Kaplan-Meier survival curves (with log-rank comparison) were used to compute the risk of developing CKD. RESULTS. Before intervention, 65 of 242 patients (27%) with T1a renal masses had CKD, including 10 of 98 patients (10%) with low SCORED values and 55 of 144 patients (38%) with high SCORED values. Interventions included radical nephrectomy (RN) in 71 patients (29%) and nephron-sparing approaches (NSA) in 171 patients (71%). Among patients with normal preoperative renal function, those with low SCORED values were less likely to develop CKD than those with high SCORED values, whether they underwent RN (38% vs 82%; P <.001) or NSA (14% vs 22%; P = .01). Multivariate analyses revealed that high SCORED values (hazard ratio [HR], 2.9; P =.02) and RN (HR, 7.0; P <.001) were significant predictors of developing CKD. CONCLUSIONS. High SCORED values were associated with a higher risk for having or developing CKD in patients who underwent intervention for small, unilateral renal masses. These data suggest that NSA should be used whenever possible, and SCORED risk stratification should be used in counseling patients regarding their potential risk of CKD.

KW - Chronic kidney disease

KW - Nephrectomy

KW - Predictive model

KW - Renal cancer

KW - Screening for Occult Renal Disease Value

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